Kim Ellen is a Counselor in Wilmington, North Carolina. Kim Ellen practices all healthcare services and medical treatments related to Counselor. The NPI Number for Kim Ellen is 1205025079. The last update date is 2009-12-16.
Kim Ellen's current location address is 615 Shipyard Blvd, Wilmington, North Carolina. You can contact this provider via phone number 9103430145. The mailing address for Kim Ellen is 615 Shipyard Blvd, Wilmington, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kim Ellen |
|---|---|
| Address | 615 Shipyard Blvd, Wilmington, North Carolina |
| Phone Number | 9103430145 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.A., L.P. |
NPI Number Detail
| NPI Number | 1205025079 |
|---|---|
| Provider Enumeration Date | 2007-10-17 |
| Last Updated Date | 2009-12-16 |
Provider Mailing Address Detail
| Address | 615 Shipyard Blvd |
|---|---|
| City | Wilmington |
| State | North Carolina (NC) |
| Post Code | 284126431 |
| Phone Number | 9103430145 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
| Licence No | 6401009255 |
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Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
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What is the Kim Ellen's 1205025079?
The Kim Ellen's NPI (National Provider Identifier) Number is 1205025079. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Kim Ellen located?
The Kim Ellen is located at 615 Shipyard Blvd, Wilmington, NC 284126431.
What is Kim Ellen's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kim Ellen's area of specialization is Counselor, and the corresponding taxonomy code that categorizes this field of practice is 101Y00000X.
On what date did the Kim Ellen receive the assignment of its 1205025079 from the Centers for Medicare & Medicaid Services?
The Kim Ellen was issued its 1205025079 by the Centers for Medicare & Medicaid Services on 2007-10-17.
As of what date were the Kim Ellen's details last updated?
The information pertaining to the Kim Ellen, including its address, specialty, and other details, was most recently updated on 2009-12-16.